Nutrition Referral Form
Penny Brohn UK Preparing for Treatment Programme
In partnership with Bristol, North Somerset and South Gloucestershire Integrated Care Board, we are proud to offer 1-to-1 nutrition consultations with our Associate Nutritionist, Kim Wilcox.
This service has been developed to ensure that people living with cancer in our local community have prompt access to personalised nutrition support, filling a gap for those who need more than general guidance, but do not meet the threshold for specialist dietitian review.
Our Preparing for Treatment Programme includes a range of live group nutrition sessions and downloadable resources that are appropriate for the majority of people. For those who need more tailored advice, this targeted service is here to help.
For patients outside BNSSG
If your patient is not under the care of NBT or UHBW, they are not eligible for this targeted nutrition service. We would encourage you to refer them directly to the dietetic department at their local trust for personalised nutrition support. They are still very welcome to access the universal offer, including live group nutrition sessions and downloadable resources, through self-referral to the Preparing for Treatment Programme.
Who can I refer?
This service is available to patients whose clinical team is based at NBT or UHBW, regardless of where the patient lives.
Patients are suitable for referral if they would benefit from personalised nutrition support but do not meet any of the following exclusion criteria:
Level of support
Nutrition pathway
Universal offer PG-SGA = 0-1 MUST = 0
Nutritional resources and access to live group sessions online at Penny Brohn UK.
Targeted offer PG-SGA = 2-3 MUST = 1
Available to clients in BNSSG only. A 1-1 nutrition session is offered to clients who would benefit from additional support but do not meet the threshold for specialist dietitian review.
Exclusion criteria
Not suitable for clients with:
- MUST score of 2 or above or PG-SGA score of 4 or above – these clients require specialist dietitian referral
- Poor oral intake
- Low BMI (below 18.5kg/m2)
- Dysphagia
- Uncontrolled diabetes management
- Poorly managed symptoms such as nausea, vomiting, diarrhoea or high output stoma
- Recent recommendation for dietary modifications for cancer-related issues, e.g. low fibre diet for risk of bowel obstruction or electrolyte restrictions
- Ongoing issues related to pancreatic exocrine insufficiency, e.g. taking Creon or Nutrizym and still experiencing steatorrhoea
If you are unsure whether your patient is suitable, please get in touch and we will be happy to advise.
Who can refer?
GPs, clinical nurse specialists, allied health professionals and leisure providers are all welcome to refer into this service.